ࡱ> 5@ Kbjbj22 (XXCDvDvDv8|vTv,yyyyyyyy6888888$Rd\yy\yyqyy66V@yx Dv ʜl 0 _ː__yq.yyy\\:=8o=2/25/08 MEDICAID 2008 LEGISLATIVE BILL TRACKING Bill #SubjectSponsorBackground/StatusHealth Care ReformHB 603Health Care Coverage Institutions of Higher EducationDel. Pena-MelnykWould require institutions of higher education in Maryland to require that all full-time students maintain health care coverage throughout their enrollment and show proof of health care coverage at least once annually; institutions must also offer health insurance coverage for an additional fee to be paid with tuition, and must consider health care coverage as an educational cost for the purpose of determining financial aid eligibility Heard: HGO, 2/21HB 737Health Care Coverage Personal ResponsibilityDel. ElliottRequires individuals w/ incomes above $50,000 to have health care coverage for at least six months of a taxable year or pay a $1,000 surcharge to the State, and requires at least one spouse in married couples w/ incomes above $100,000 to have health care coverage or pay a $2,000 surcharge (plus $1,000 for each dependent child without coverage); the Comptroller is authorized to make exceptions under certain circumstances; any funds collected are to be distributed to the Health Care Coverage Fund, to be used for a Medicaid expansion or subsidies of private insurance Hearing: HGO, 2/28 @ 1 pmHB 1125Maryland Universal Health Care PlanDel. Mont-gomerySingle-payer universal coverage bill; Medicaid funds (other than nursing home and Medicare-related payments) to be transferred into Md. Universal Health Care Trust Fund; DHMH to apply for a waiver to receive federal matching funds Hearing: HGO, 3/13 @ 1 pm Bill #SubjectSponsorBackground/StatusBudgetHB 101 SB 91Budget Reconciliation & Financing ActSpeaker Busch President MillerTransfers $7 million from Rate Stabilization Account to Medicaid in FY09 and transfers $14,275,000 to Health Care Coverage Fund in FY09 and $62 million in FY10 HB 101: hearing in APP, 2/28 @ 1 pm SB 91: hearing in B & T, 2/27 @ 1 pmHB 1284 SB 545Md. Health Care Provider Rate Stabilization Account Transfer of FundsDel. Conway Sen. CurrieTransfers $7 million from Rate Stabilization Account to Medicaid in FY09 and transfers $14,275,000 to Health Care Coverage Fund in FY09 and $62 million in FY10 Hearing: APP, 2/28 @ 1 pm Hearing: B & T, 2/27 @ 1 pmHB 602Md. Health Care Provider Rate Stabilization Fund Transfer of Moneys to Rainy Day FundDel. DonoghueTransfers $84 million in Rate Stabilization Account to Rainy Day Fund in FY09 Heard: HGO, 2/21HB 1093Health Care Coverage Fund Tax on Health Insurance Premiums Access to Health CareDel. MorhaimAdds 3% premium tax on health insurance premiums and directs one-third of those funds to the Health Care Coverage Fund; value of the premium tax exemption still based on 2% rate Hearing: W & M, 3/12 @ 1 pm Bill #SubjectSponsorBackground/StatusPharmacyHB 1429Md. Medical Assistance Program Pharmacy Dispensing FeesDel. JamesRequires DHMH to raise pharmacy dispensing fees 45 days after implementing the federal upper payment limits mandated by the federal Deficit Reduction Act of 2005, and every two years thereafter; DHMH must also set initial fee increase based on findings of 2006 U. of Md. School of Pharmacy ReportHB 120 SB 724Pharmacy Benefits Managers TransparencyDel. Bromwell Sen. Klaus-meierEstablishes disclosure requirements for PBMs in the State; does not apply to MCOs HB 120: heard in HGO, 2/7 SB 724: hearing in FIN, 3/12 @ 1 pmHB 243 SB 726Pharmacy Benefits Managers Choice of PharmacyDel. Benson Sen. Klaus-meierRequires insurance policies & PBMs to allow enrollees a choice of pharmacy or pharmacist within the policys network; does not apply to MCOs HB 243: heard in HGO, 2/7 SB 726: hearing in FIN, 3/12 @ 1 pmHB 257 SB 725Pharmacy Benefits Managers Contracts w/ PharmaciesDel. Kullen Sen. Klaus-meierEstablishes regulations governing contracts between PBMs & providers and requires PBMs to enter into contracts before providing services to a purchaser; also establishes provisions governing audits of pharmacies or claims by PBMs HB 257: heard in HGO, 2/7 SB 725: hearing in FIN, 3/12 @ 1 pmHB 343 SB 723Pharmacy Benefits Managers Prescription Drug SubstitutionDel. Kipke Sen. Klaus-meierProhibits PBMs from substituting another prescription drug for a prescribed drug unless it benefits the beneficiary or results in financial savings and benefits the purchaser (PBMs must disclose to the purchaser any benefit or payment it receives); prescriber must give authorization before making substitution HB 343: heard in HGO, 2/7 SB 723: hearing in FIN, 3/12 @ 1 pmHB 419 SB 722Pharmacy Benefits Managers RegistrationDel. Elliott Sen. Klaus-meierRequires PBMs who conduct business in the State to register w/ MIA HB 419: heard in HGO, 2/7 SB 722: hearing in FIN, 3/12 @ 1 pmHB 580 SB 720Pharmacy Benefits Managers Pharmacy & Therapeutics CommitteeDel. Oaks Sen. Klaus-meierRequires each member of a P & T committee to be a physician or authorized prescriber, a pharmacist or a faculty member of an academic medical center; a majority of committee members may not be employed by the PBM, and PBMs may not require a pharmacy to participate in a P & T committee, and must reimburse any participating pharmacies for related expenses HB 580: heard in HGO, 2/7 SB 720: hearing in FIN, 3/12 @ 1 pmHB 435Pharmacists Generic Drugs Treatment of Epileptic SeizuresDel. Pena-MelnykProhibits pharmacists from substituting a generically-equivalent drug or another brand-name drug for an anti-epileptic drug without the prior notification & written consent of the prescriber, patient or their parent/legal guardian/spouse WITHDRAWN Bill #SubjectSponsorBackground/StatusPharmacy (contd)HB 772Pharmacists Substitution of Generic Drugs or Device Products Consent of Consumers or Authorized PrescribersDel. RobinsonPrevents pharmacists from substituting a generic drug for a brand-name drug unless the consumer or provider consent in writing Hearing: HGO, 2/28 @ 1 pmHB 514 SB 775Md. Medbank Program FundingDel. Donoghue Sen. PughProvides $425,000 from Senior Prescription Drug Program surplus in FY09 HB 514: heard in HGO, 2/14 SB 775: hearing in FIN, 2/27 @ 1 pmHB 525Prescription Drug Monitoring ProgramDel. KullenEstablishes a prescription drug monitoring program that electronically collects and stores data on monitored drugs; monitored drugs are defined as Schedule II, III or IV drugs Heard: HGO, 2/14HB 37Medicare Part D Donut Hole Tax Assistance ActDel. MannoProvides 50% deduction of Part D donut hole expenses to enrollees of Senior Prescription Drug Assistance Program (up to 7.5% of enrollees adjusted gross income) Heard in W & M, 2/6HB 1492 SB 906Senior Prescription Drug Assistance Program Subsidy for Medicare Part D Coverage GapSpeaker Busch President MillerCareFirst to provide $4 million in funding for SPDAP to provide subsidies for enrollees donut hole costs Bill #SubjectSponsorBackground/StatusLong-Term CareHB 218DHMH Living At Home Waiver ProgramDel. HammenTransfers Living At Home waiver program from DHR statute into DHMH statute Heard: HGO, 2/12HB 783Community Attendant Services & Supports Program Personal Assistants Requirements for Family MembersDel. RobinsonRequires that family members who provide services to Living At Home waiver enrollees receive nursing training and training on business operations (including scheduling and financial management) Hearing: HGO, 3/4 @ 1 pmHB 951Living At Home Waiver Program Case Management EligibilityDel. KullenRequires nursing homes to notify case management entity within 24 hours of admittance of a potential Medicaid enrollee; nursing facilities shall allow representatives of the case management entity access to the nursing home and collaborate w/ them to assess the individuals eligibility; if they are deemed eligible, nursing home staff and representatives of the case management entity shall develop a transition plan in accordance w/ the individuals needs & preferences; case management entity to provide outreach & training to nursing home staff to help identify individuals eligible for transition services upon admission to the nursing home Hearing: HGO, 3/11 @ 1 pmHB 1379Health Insurance Older Adults Waiver ExpansionDel. IveyEstablishes a special non-lapsing Waiver for Older Adults Expansion Fund (using Provider Rate Stabilization Fund money) to finance 250 additional Older Adults Waiver slots in FY10-12 Hearing: HGO, 3/13 @ 1 pmHB 1395Chronic Care & Prevention Partnership ActDel. TarrantEstablishes a Chronic Care & Prevention Program in DHMH for anyone who participates in a State health plan, including Medicaid & MCHP; the program is the States plan for developing a regionally-based foundation for chronic disease prevention & treatment, which includes forming regional chronic care & prevention partnerships, developing options for directing chronic care resources to the partnerships, community outreach & education and coordinating w/ chronic care IT system initiatives; also creates a task force on Chronic Care & Prevention Hearing: HGO, 3/13 @ 1 pmHB 807Task Force to Study Matters Relating to Long-Term Care FacilitiesDel. JamesEstablishes a task force to study financial issues related to long-term care facilities regarding ownership, financial solvency and liability insurance and submit a report to the Governor & General Assembly by Dec. 1, 2009; DHMH to participate in task force, DLS to provide staff Hearing: HGO, 3/4 @ 1 pmSB 682 HB 1452Medical Assistance Program Long-Term Care Eligibility Program Consolidation PlanSen. Middleton Del. WeldonRequires DHMH & DHR, in consolidation w/ Lifespan & HFAM, to develop a plan to integrate the functions necessary for eligibility determinations for Medicaid long-term care services; the plan shall include (1) the transfer of the DHR workforce, including local DSSs, to DHMH, (2) uniform procedures, guidelines & forms to be used when making long-term care eligibility determinations, and (3) streamlined regulations policies & procedures related to the application for long-term care services; DHMH & DHR to report to the Governor & General Assembly by Nov. 1, 2008SB 677 HB 809Nursing Facilities Accountability Measures Pay for PerformanceSen. Garagiola Del. JamesRepeals nursing home accountability measures in last years quality assessment bill and instead requires DHMH to develop a plan for quality measures (including consideration of a pilot program in SB 677), by Dec. 1, 2008 Bill #SubjectSponsorBackground/Status MCOsHB 395Health Insurance Carriers ReportingDel. HammenRepeals requirement that MCOs file a consolidated financial statement w/ MIA, and instead requires them to file a report by March 1 each year that shows their financial condition on the last day of the preceding calendar year and on June 1 each year file an audited financial report for the preceding calendar year; both new reports are to be made public MIA bill 3RD READING PASSEDHB 1081Health Insurance Reimbursement of Providers of Health Care Services ClaimsDel. LoveProhibits MCOs from downcoding claims for services that are rendered in compliance w/ federal EMTALA law & regulations; MCOs are also required to conduct an audit of EMTALA-compliant services that are rendered to HealthChoice enrollees Hearing: HGO, 2/28 @ 1 pmHB 1104 SB 774Md. Medical Assistance Program MCOs Hospital Ancillary ServicesDel. Tarrant Sen. PughRequires MCOs to separately determine the medical necessity of ancillary services from the medical necessity of the hospitalization, and MCOs may not deny payment for ancillary services if they determine that the hospitalization was not medically-necessary HB 1104: hearing in HGO, 3/11 @ 1 pm SB 774: hearing in FIN, 2/27 @ 1 pmHB 1161 SB 719Health Insurance Carrier Provider Panels Standards for Availability of Health Care ProvidersDel. Bromwell Sen. Klaus-meierWould give MIA the authority to review and approve on an annual basis a carriers (including MCOs) standards for availability of provider to meet the health care needs of its enrollees; carriers would be required to submit data on appointment wait times, provider-enrollee ratios by specialty, primary care provider-enrollee ratios, geographic accessibility, hours of operation and the percentage of enrollees who were provided services inside a hospital or outside a hospital by out-of-network providers HB 1161: hearing in HGO, 3/6 @ 1 pm SB 719: heard in FIN, 2/20HB 1219 SB 811Health Insurance Health Care Provider Panels Provider ContractsDel. Kach Sen. PipkinRepeals provisions prohibiting a carrier from requiring a provider, as a condition of participation on a provider panel of a health benefit plan to also serve on a provider panel for another one of the carriers health benefit plans, and repeals the exception that allows Medicaid MCOs to require a provider, as a condition of participation on a provider panel for one or more of the carriers health benefit plans, to serve on an MCO provider panel as well; instead, the bill states that a provider contract may not require a provider, as a condition of participating in a non-HMO provider panel, to participate in an HMO provider panel or dental provider panel; provider contracts may require a provider to participate in an MCO HB 1219: hearing in HGO, 3/6 @ 1 pm SB 811: heard in FIN, 2/20HB 1454Md. Medical Assistance Program Hospitals MCOs Access & Health Care Disparities EliminationDel Nathan-PulliamRequires DHMH to require academic health centers and their affiliated specialty care networks to contract w/ MCOs to provide hospital & specialty care to Medicaid enrollees upon request by an MCO; to qualify, an MCO must have membership that is at least 65% African-American, agree to pay a minimum of the current Medicaid fee for specialty rates and the appropriate HSCRC rates Bill #SubjectSponsorBackground/Status Other Medicaid-Related BillsHB 115Medical Assistance Program & MCHP Statements on State-Issued Check StubsDel. TarrantRequires statement to be placed on State-issued tax refund checks, employee paychecks and vendor payment checks advising individuals who cannot afford health insurance that they may be eligible for Medicaid or MCHP; amended to require statement to be printed on check stubs instead of actual checks, and eliminates vendor payment checks and adds State-issued child support checks 3RD READING PASSED AS AMENDEDHB 1099Task Force to Increase the Enrollment of Students in Medicaid & MCHPDel. TarrantCreates task force to study strategies to monitor& ensure that any student in a public school who is eligible for Medicaid or MCHP is enrolled; task force to report to the Governor & General Assembly by July 1, 2009 Heard: HGO, 2/19HB 1153Comptroller Eligibility for the Md. Medical Assistance Program or MCHPDel. HuckerRequires Comptroller to provide notice to individuals w/ a dependent child and who have incomes below 300% of poverty of that they may be eligible for Medicaid or MCHP, and provide them w/ information on how to enroll; begins w/ 2009 tax year Heard: HGO, 2/19HB 1391Kids First ActDel. MizeurRequires Comptroller to provide notice to individuals w/ a dependent child and who have incomes below 300% of poverty of that they may be eligible for Medicaid or MCHP, and provide them w/ information on how to enroll; also requires children to have health care coverage before their parents can deduct an exemption for them on their tax return Hearing: HGO, 3/13 @ 1 pm HB 1404Eliminating Barriers to Enrollment ActDel. MizeurRequires 12-month guaranteed eligibility for Medicaid & MCHP enrollees, along w/ presumptive eligibility Hearing: HGO, 3/13 @ 1 pmHB 1406Foster Kids Coverage ActDel. MizeurRequires Medicaid coverage of independent foster care adolescents (under the age of 21 and who were in State foster care on their 18th birthday) who have incomes below 300% of poverty Hearing: HGO, 3/11 @ 1 pmHB 235Md. Medical Assistance Program Emergency Services Transporters PaymentsDel. HammenRepeals $100 cap on payments for emergency services transporters 3RD READING PASSEDHB 883Correctional Facilities Eligibility for Parole Medical ParoleDel. VallarioAllows inmates who are so debilitated or incapacitated by a medical or mental health condition, disease or syndrome as to be physically-incapable of presenting a danger to society may be released on medical parole at any time during the term of the inmates sentence DPSCS bill Hearing: JUD, 3/4 @ 1 pmHB 1522Md. Health Care Provider Rate Stabilization Fund Allocations to and Disbursements from the Medical Assistance Program AccountDel. HammenWould allow dentists to receive allocations from the Provider Rate Stabilization Fund HB 1532Health Direct Access of State Agencies to Criminal Background Checks Conducted by DPSCSDel. 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